24th Annual Clarke Family Medical Ethics Conference

On March 27th-29th, 2009, approximately one hundred doctors, nurses, medical students, medical ethicists, and Notre Dame undergraduates came together for our 24th annual Notre Dame Medical Ethics conference. As usual, the Notre Dame Alumni Association joined the Center in sponsoring the conference, which took place on campus at the Center for Continuing Education in McKenna Hall. The conference is designed to serve current and future medical professionals, providing them with an opportunity to join with others to reflect thoughtfully on the often complex ethical questions and problems that arise in medicine. Among medical ethics conferences, our conference is distinctive in encouraging theologically-informed discussions and in placing emphasis on small-group discussions of physician-submitted cases.

The first session of our conference dealt with challenges associated with finding a workable, accurate, medical definition of death. As the discussed cases made apparent, both which definition is chosen and who is deemed to have the authority to choose will have serious practical consequences for issues such as organ donation eligibility as well as treatment continuance and cessation. Two of the discussed cases also brought out some practical difficulties associated with applying the now widely-accepted brain-death criterion of death: for one class of persons—newborns—very rarely are physicians able to verify brain death.

On the first evening of the conference, we held our annual J. Philip Clarke Family lecture, a lecture open not only to our conference attendees but also to the Notre Dame, St. Mary’s, and greater South Bend communities. This year’s speaker was Edmund Pellegrino , M.D., Professor Emeritus of Medicine and Medical Ethics at the Center for Bioethics at Georgetown University Medical Center. This was Dr. Pellegrino’s third time giving the Clarke Lecture, and the title of his address was “A Moral Foundation for the Helping Professions: Medicine, Law, Ministry, and Teaching.”

Following the Clarke lecture, Dr. Pellegrino participated in a book signing for two recently-published books: The Philosophy of Medicine Reborn: A Pellegrino Reader, which was published in the Center’s book series, and Medical Ethics at Notre Dame: The J. Philip Clarke Family Lectures 1988-1999, a collection of the first twelve Clarke lectures with responses. During the third session, participants tackled problems of obtaining informed consent. Physicians discussed both what is required for full and proper informed consent and who is capable of giving true consent. They considered whether doctors are obligated to volunteer information about which hospitals and doctors can provide patients with the best treatment. The participants also discussed tough cases of consent to treatment involving minors and the very poor participating in medical research for pay.

For the fourth session of our conference, we welcomed Notre Dame Economics Professor Bill Evans, who gave detailed assessments of both the current state of the United States health care system and President Obama’s proposals for health care reform. At the request of several conference attendees, the slides from Prof. Evans’ lecture are available online at the Center’s website.

In the fifth session, “Medicine and Money,” participants considered problems that have arisen in the health care delivery system as hospitals, governments, and individuals have tried to deal with the realities of limited financial resources. One of the most provocative cases involved hospitals, including at least one Catholic facility, that have resorted to deporting indigent,
uninsured immigrants in an effort to balance their budgets.

On Saturday afternoon, participants had a choice of attending one of three panel discussions. The topics for these discussions were: the recent document from the Vatican’s Congregation for the Doctrine of the Faith, Dignitas Personae, a document on a series of recommended changes to resident duty hours that the ACGME (the organization that accredits medical schools in the U.S.) is now considering; and the appropriate response of health care professionals when they conflict with their colleagues on when and how to prescribe pain medication. dimensions of science and technology.

On Sunday morning, we had our usual “roundtable discussion,” a wrap-up session in which participants are invited to raise questions for all present to consider. These questions can be on topics discussed in previous conference sessions or on entirely new topics. Some of the most memorable discussions in this year’s roundtable were prompted by physicians seeking advice on how to handle some of the tough cases they had encountered in their own practices.

Science, Beauty, and the Transcendentals

What is the nature of beauty, and what does it have to do with the day-to-day teaching and research activities of the scientist? These were the questions pursued by Notre Dame’s new Dean of Engineering, Dr. Peter Kilpatrick, in his Fall 2008 Schmitt Lecture, “Science, Beauty and the Transcendentals,” delivered to an appreciative audience in the main auditorium of McKenna Hall on Tuesday afternoon, December 2.

Drawing upon such thinkers as St. Thomas Aquinas, Josef Pieper, and Jacques Maritain, Dr. Kilpatrick articulated a conception of beauty as radiant form. As Maritain puts it, “form” is the proper principle of intelligibility, the proper clarity of everything… a vestige or ray of the creative intelligence at the heart of created being.” The beauty of something thus comes down to the clarity or splendor of its form, a clarity which images and beckons us toward the perfect clarity of God’s own being. The Greek word for beauty, in fact, is derived from the Greek verb “to call.”

With an inventive PowerPoint presentation, Dr. Kilpatrick then showed various images of physical nature which captivate us with their beauty.

All of which, however, led to the question: even if we take a moment to appreciate the beauty of physical nature, what does such an attitude have to do with the real work of a scientist? Dr. Kilpatrick’s reply was that the appreciation of beauty involves a particular act of the mind which the scientist too often neglects. That act of the mind is the intuitive act, the act by which the mind simply “drinks in” the intelligibility of reality. This understanding of mind as receptive of the intelligible forms of things guards the scientist from thinking that human thinking is exclusively analytical. The point is not to denigrate this activity of the mind, which is absolutely necessary to the pursuit of truth, and indeed to the full appreciation of beauty. Rather, Dr. Kilpatrick’s point was to remind his audience that truth is more about vision than critical analysis; more about receptivity than research. Truth is above all a gift, the gift of the mysterious intelligibility at the most intimate level of created reality, a mystery God delivers to us through the attractiveness of beauty.

After a public reception following Dr. Kilpatrick’s lecture, some thirty-five specially-invited guests, including many of the graduate students who are Schmitt Fellows in the Schools of Science and Engineering, joined Dr. Kilpatrick and Center director David Solomon at The Morris Inn for a dinner in Dr. Kilpatrick’s honor, where after dessert there was more spirited discussion of the themes of the day’s lecture.

The charge of the Schmitt Lecture Series is a broad but essential one: to reflect on the ethical, political and religious dimensions of science and technology. The Schmitt Fellows are the principal recipients of the generosity of the Arthur J. Schmitt Foundation to the University of Notre Dame. It was for the sake of honoring that generosity that the Schmitt Lecture Series was founded.

On Dying

Breaking Bread, our semi-annual dinner and evening of spiritual discussion for Notre Dame students and faculty, continues to draw great interest from students and professors alike. While no longer able to boast of the Notre Dame Stadium Press Box as its venue, the dinner nevertheless remains popular among students for its exceptional physical and spiritual nourishment. Attendees enjoy a thought-provoking speaker, intellectually stimulating dinner conversation, and delicious food.

At this fall’s Breaking Bread event on November 18, 2008, Robert B. Sloan Jr., president of Houston Baptist University, delivered a stirring reflection on the Christian’s outlook on death. Sloan, recently diagnosed with prostate cancer, spoke of realizing his own mortality, which challenged him to more closely examine the Christian view of death.

Using the example of Paul and other early Christians, Sloan described how their outlook on death developed as they realized the return of Christ would not come in their lifetime. In his letter to the Philippians, Paul, imprisoned and believing his death to be imminent, wrote to the Church in Philippi to counsel them on the subject of death. Sloan stated that for Paul, his faithful death was the final step in his conformity to Christ. Sloan also discussed Paul’s desire to know God through his death. As Paul said, “[T]o live is Christ, and to die is gain” (Philippians 1:21). Sloan concluded with a word of advice to the students gathered at the dinner. “We are not called to live lives based on apparent success,” Sloan said. He further challenged young people to think more about their own deaths, so that it may direct them how to live.

Those who attended the dinner received a complimentary copy of As I Lay Dying, a meditation on “facing death, and living again,” by the recently departed Rev. Richard John Neuhaus, which suddenly became all the more poignant this January. May he rest in peace.

The Family: Searching for Fairest Love

In his 1994 Letter to Families, Pope John Paul II stated that "only the truth will prepare you for a love which can be called 'fairest love.' The contemporary family, like families in every age, is searching for fairest love." Pope Benedict, too, has made the family a central theme of his pontificate. As recently as his message on the World Day of Peace on January 1, 2008, the Holy Father said, "The natural family, as an intimate communion of life and love, based on marriage between a man and a woman, constitutes "the primary place of 'humanization' for the person and society," and a "cradle of life and love." By examining the family, its origins, and status in society and under the law, we at the Center hope to address this multi-dimensional crisis and instill hope for the future of the family.

The weekend of November 6-8 welcomed over 400 scholars from Catholic, Christian, and secular institutions—as well as students and the intellectually curious—to Notre Dame’s McKenna Hall to discuss the fragile modern conception of “the family” and its implications for traditional family values in America and across the globe. John Finnis, Biolchini Family Professor of Law at the University of Notre Dame and Oxford University, delivered the Thursday evening Josef Pieper Keynote Lecture, “On Retranslating Humanae Vitae.” Before presenting an in-depth and engaging analysis of Pope John Paul II’s encyclical, he was introduced by longtime friend and colleague Gerard V. Bradley who expressed a hope for the eventual incorporation of American slang in the vocabulary of the native Australian, Brit-educated natural lawyer. The auditorium rang with laughter, and the busy weekend kicked off to an amiable and enthusiastic start.

The remainder of the weekend was filled with an astonishingly diverse range of presentations that would have needed to be spread out over two weeks if one was to attend each one. Unfortunately, as is the case every year, the conference attendants had to limit their choices. Some highlights of the numerous lectures were:

Thomas Hibbs’s engaging lecture on “The Family: The Crisis and the Romantic Temptation”; William Saunders’s reflections on marital union with regard to the Supreme Court and International Human Rights Law; Philip Bess’s architectural analysis of the Notre Dame campus and its potential to be a true Aristotelian polis; Monsignor Charles Brown’s discussion of the twenty-first century’s setting for family structure and ecclesiological progression; and Helen Alvaré’s thoughtful meditations on the Catholic view of the law directing intimate partnerships.

Each year the conference is complemented by two special liturgies, and this year was no exception. On Friday night the Notre Dame Filiae Mariae organized a Mass in the beautiful Alumni Hall chapel with Monsignor Charles Brown presiding.

The conference came to an enjoyable conclusion on Saturday night with a festive banquet where old and new friends had the opportunity to mull over these topics one last time. After dinner, David Solomon, Director of the Center, offered some thoughtful remarks on how to carry on fostering a healthier conception of the family within our communities.

This ninth edition of the Fall Conference provided a venue for discussion of one of the most fundamental aspects of our humanity—the family. It also celebrated in a special way the anniversaries of two important papal documents. In 2008, Pope John Paul II's apostolic letter, Mulieris Dignitatem, enjoys its 20th anniversary, and Pope Paul VI's encyclical, Humanae Vitae, celebrates its 40th anniversary. A conference devoted to the family was a perfect opportunity to reflect on the importance of these two documents.

This incredible event was made possible again by the generosity of the Strake Foundation, the Maas Family Endowment for Excellence and by a grant from Our Sunday Visitor, and we at the Center are especially grateful. We invite all of you to The Summons of Freedom: Virtue, Sacrifice, and the Common Good, the 10th anniversary edition of our Fall Conference which will take place November 12-14, 2009 in McKenna Hall here at Notre Dame. We look forward to seeing you all there!

What Criteria, for an Otherwise Pro-life Voter, Constitutes a Sufficient Proportionate Reason to Justify a Vote for a Pro-choice Candidate?

Since its establishment last fall, the Notre Dame Fund to Protect Human Life has had a fruitful year which promises to serve as a strong foundation for the future. As we described in our last newsletter, the Fund’s inaugural event was a discussion between two Notre Dame law professors examining the 2008 presidential election in terms of the life issues. Vincent Rougeau, an associate professor and member of Barack Obama’s National Catholic Advisory Council Steering Committee, and Gerard Bradley, professor and member of the Catholics for McCain National Steering Committee discussed the question, “What criteria, for an otherwise pro-life voter, constitutes a sufficient proportionate reason to justify a vote for a pro-choice candidate?” And, in late January, the Fund sponsored a trip to Washington D.C. for the annual March for Life, helping to provide transportation and other expenses for over 300 Notre Dame students, as well as the staff of the Center for Ethics and Culture and their families.

Wit's Way to Wisdom: Four Catholic Satirists

Every fall since 2002, the Center has sponsored the Catholic Culture Series, a set of lectures focused on prominent figures in the Catholic literary tradition. The series sprang from the Center's desire to expose Notre Dame undergraduates- and the entire Notre Dame community- to the richness of the Catholic literary heritage. Highlighting such major Catholic figures as Flannery O'Connor, G.K. Chesterton, Graham Greene, Walker Percy, and J.R.R. Tolkien, we at the Center hope to promote such writers both for the quality of their works and the uniquely Catholic dimension of their literary perspectives.

Entitled "Wit's Way to Wisdom: Four Catholic Satirists," this fall's edition of the Catholic Culture series explored the work of Evelyn Waugh, Baron Corvo, Hilaire Belloc, and Oscar Wilde through five lectures spread over six weeks. Since classical times, satire has been a keen weapon of criticism used by rhetoricians in western civilization. Some of the greatest satirists of modern times have been Catholics, yet from the Catholic perspective there are also reservations about whether satire is truly a meaningful instrument in a dialogue of evangelization. Our five speakers contributed to this debate by examining the critique of modern society that these four men offered through their satire.

1. Rev. Paul Mankowski, SJ, a scholar of Scripture and Hebrew at the Pontifical Biblical Institute of Rome, and a native of South Bend, opened the dialogue with his Sept. 23 lecture on Evelyn Waugh. Mankowski raised the question, "Can a Catholic in good conscience be a satirist?" and answered it by characterizing Waugh's novels: "Waugh did not like his work pigeon-holed. His satire was not composed of pithy one-liners, but rather had an emancipating element." He acknowledged that satire could be used to be hurtful, but that Waugh's stories have the substantial positive truth of the Catholic faith behind them.

2. Ralph McInerny, a philosophy professor at Notre Dame for over 50 years, delivered the only lecture in the country on Baron Corvo at Notre Dame on Sept. 30. Born Frederick Rolf, Baron Corvo is a controversial figure because he is best known for his egotistical, solipsistic personality. McInerny agreed that in Corvo's case, the mean-spirited and self-absorbed character of his work reveals the dangers that can overtake Catholic satirists.

3. Rev. Marvin O'Connell, Notre Dame history professor emeritus continued the series by offering the life of Hilaire Belloc for our inspection on Oct. 7. O'Connell praised Belloc for his "deep perception of human grandeur and human folly," that came with an "uncanny capacity to see both the forest and the trees," that made him a great historian.

4. Joseph Pearce, Writer in Residence and associate professor of literature at Ave Maria University and internationally acclaimed author of numerous books, delivered the lecture on Oscar Wilde on Oct. 14. Pearce argued that Wilde is misinterpreted as a gay icon by those who do not pay adequate attention to his satire, in which he clearly condemns the promiscuity and self-absorption of his characters. His death-bed conversion is the final word on his life.

5. Rev. Charlie Gordon, CSC, from the University of Portland, concluded the series with his lecture, "Waugh Revisited" on Oct. 28. He focused on Brideshead Revisited, which highlights the societal tension between the desire to be ephemerally praised in public, and the competing desire to anchor one's life on the eternal.

An Evening of Angelus at Notre Dame

A near-capacity crowd attended the Center’s second annual “An Evening of Angelus at Notre Dame” film screening, held in the state-of-the-art Browning Cinema in Notre Dame’s DeBartolo Performing Arts Center on Thursday evening, May 1, 2008. Each year “An Evening of Angelus at Notre Dame” features four of the winning filmmakers from the Angelus Awards Student Film Festival sponsored by Family Theater Productions in Hollywood. The Angelus Student Film Festival honors future filmmakers as they explore and create works that respect the dignity of the human person. The Angelus Awards was voted by Moviemaker magazine as the “Best Bet” among student film festivals for young filmmakers looking to make a career in Hollywood. This year the Angelus screening featured the following directors and films:

Sean Overbeeke – Christmas Wish List
Sean Overbeeke attended the University of North Carolina at Chapel Hill where he majored in Communications with a concentration in media production. In 2006 Sean won a Student Academy Award for his short film Christmas Wish List, which he produced, wrote and directed. Since then, Sean has been producing television documentaries for Discovery Networks. He is currently the series producer for “Raising 17 Children” which premieres on TLC in August 2008. Sean lives in Los Angeles where he is also working with Sly Dog Films to produce his first feature length film about a 12-year-old North Carolina female stock car racer.

Lowell Frank and Destin Daniel Cretton – Deacon’s Mondays
Deacon’s Mondays was inspired by Lowell’s parttime job, and always growing passion, as a landscaper/ horticulture artist. Lowell Frank and Destin Daniel Cretton have been working together since meeting during their last semester at Point Loma Nazarene University in 2001. The duo has completed seven short films as well as a feature length documentary entitled, Drakmar: A Vassal’s Journey, which aired on HBO Family in June of 2007. Their films have played in festivals all over the world, garnering recognition and awards, including national finalist for the 2006 (Bartholomew’s Song) and 2007 (Deacon’s Mondays) Student Academy Awards. Deacon’s Mondays most recently won HBO Films Best Student Film Award at the 2007 Savannah Film Festival. It was shot on a $2500 budget and took 3 years to finish.

Shyam Balsé – Monsoon
Shyam has written and produced dozens of hours of programming for multiple outlets including Paramount Television and the Discovery Channel. He’s had the opportunity to work with Robert Zemeckis, and produced a feature mockumentary with Leslie Zemeckis. Shyam graduated with an MFA in Film Production at the University of Southern California. After graduating, he started a production company with producer/director Joseph Itaya called Tempered Entertainment. Shyam wrote and directed Monsoon as his thesis project. It has screened in over 35 film festivals worldwide and has won 16 awards.

Nicholas Ozeki – Mamitas
Nicholas is a graduate of Amherst College where he majored in English with an emphasis in film studies. He recently graduated from Chapman’s graduate film school. He has written and directed several films, one of which was nominated for Best Picture at Chapman’s annual Cecil Awards in 2006. In 2007 he was again nominated, this time for his thesis film Mamitas, and was awarded Best Picture and Best Direction for his work. He was also given the school’s coveted Einstein Award in 2007 for Excellence in Academics and Filmmaking. He is currently teaching cinematography at New York Film Academy located in Universal City on a part-time basis. A feature script for Mamitas is currently in the works.

The screening of the films was followed by a Q&A with the filmmakers, moderated by Angelus director, Monika Moreno.

The English Catholic Novel Today: Alive and Well

On Wednesday evening, April 23, 2008, the Center sponsored a lecture by Notre Dame’s own Marian Crowe, “The English Catholic Novel Today: Alive and Well.” In front of an enthusiastic audience in the Hesburgh Center for Peace Studies, Dr. Crowe developed themes from her recently published book, Aiming at Heaven, Getting the Earth: the English Catholic Novel Today (Lexington Books, 2007). In the novels of Alice Thomas Ellis, David Lodge, Sara Maitland, and Piers Paul Read, Dr. Crowe argued, we find a rich sampling of possibilities for the Catholic novel in the post-Vatican II world. After the lecture Dr. Crowe greeted her audience at a reception in the Great Hall of the Hesburgh Center.

Physics, Ethics, and the Life of Practice

The spring Schmitt Lecture took place on April 8, 2008, and was delivered by the Center’s senior research fellow, Alasdair MacIntyre. Professor MacIntyre’s lecture, entitled “Physics, Ethics, and the Life of Practice,” addressed the question of what contexts are best suited to the development of moral character, and argued that far more can be learned about acquiring virtue from a practice such as physics than from academic courses in ethics.

Practicing Medical Ethics, Think about the Hard Questions

The Practicing Medical Ethics course is our one-unit, day-long introduction into the interesting yet thorny field of medical ethics. The course is intended to familiarize students with some of the central issues in medical ethics and provide an opportunity for thoughtful and stimulating discussion about some of the hotly debated issues that dominate the public square.

When asked if doctors have an obligation to tell their patients the truth, the typical gut reaction is to answer this question affirmatively. This first session featured two cases that were contributed to the 2008 Medical Ethics Conference by a practicing physician. They bring to light the complications in the doctor-patient relationship, the complexity of human lives, and questions about the extent of a doctor’s obligation to tell the truth.

In the second session, students considered the implications of genetic testing and preimplantation genetic diagnosis (PGD). Currently, the abortion of fetuses that are afflicted with such maladies as Down Syndrome and Spina Bifida is accepted medical practice. Is the use of preimplantation genetic diagnosis to discard embryos that display certain predispositions different in any ethically relevant way? Is the use of PGD permissible to discard embryos that have the predisposition to develop afflictions that show up not at birth or early childhood, but much later in life?

What is the point of health care? Is health care a business or a profession? What are the obligations of a health care professional with respect to the sick at large and to his own home community? These are the questions that students faced in this third session, in which we asked them to reflect upon the nature of health care. The students also read an excerpt of The Rebirth of the Clinic by Daniel P. Sulmasy, O.F.M., M.D., Ph.D., the Clarke lecturer for the 2008 Medical Ethics Conference.